MEDICARE: EMILY VELOTTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	51968-20	WI
2	207W00000X	Ophthalmology Physician	125.047542	IL
3	207W00000X	Ophthalmology Physician	036127254	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063672723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY VELOTTA MD

Provider Business Mailing Address
First Line	:	333 E IL ROUTE 83 STE 106
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-4278
Country	:	US
Telephone Number	:	847-566-5300
Fax Number	:	847-566-5310

Provider Business Practice Location Address
First Line	:	333 E IL ROUTE 83
Second Line	:	SUITE 106
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-4214
Country	:	US
Telephone Number	:	847-556-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	02/28/2024

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Directions to “ EMILY VELOTTA MD” Practice Location

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